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Purpose The present study investigated the correlation between the nutritional status and prognosis of COVID-19 patients, and analyzed the epidemiological characteristics of COVID-19 patients with different nutritional status. Methods 429 patients who were diagnosed positive for COVTD-19 in Hubei Provincial Hospital of Traditional Chinese Medicine from December 2019 to March 2020 were selected and divided into different groups based on Controlling Nutritional Status (CONUT) score (0–4: the low CONUT score group; 5–12: the high CONUT score group). Multivariate logistic regression analysis was applied to investigate the effects of CONUT score on prognosis. Results The total score of admission status of patients with higher CONUT score was higher than that of those with lower CONUT score (χ2 = 7.152, P = 0.007). The number of adverse outcomes of female was higher than that of male (χ2 = 10.253, P = 0.001). The number of adverse outcomes was higher for patients with smoking history (P = 0.004) or hypertension (χ2 = 11.240, P = 0.001) than those without. Also, the number of adverse outcomes was higher for older patients than younger ones (χ2 = 15.681, P < 0.001). Patients with adverse outcomes had lower urine red blood cell count than patients without adverse outcomes (χ2 = 5.029, P = 0.025). However, BMI, drinking history and diabetes did not show correlation with the prognosis of COVID-19 (P > 0.05). Among patients ≥ 61 years old, the risk of adverse outcomes in the high CONUT score group was 6.191 times that of the low CONUT score group (OR = 6.191, 95% CI: 1.431–26.785). Among the non-diabetic patients, the risk of adverse outcomes in the high CONUT group was 11.678 times that of the low CONUT group (OR = 11.678, 95% CI: 2.754–49.41). For the patients who had a total score of admission status < 6, the risk of adverse outcomes in the high CONUT score group was 8.216 times that of the low CONUT score group (OR = 8.216, 95% CI: 2.439–27.682). Conclusion COVID-19 patients with good nutritional status showed a small chance to have adverse outcomes. Gender, age, hypertension, the number of urine red blood cell count and CONUT score affected the adverse outcomes of patients.

To explore the mediating role of psychological resilience to childhood abuse and binge eating. This study assessed the childhood abuse, binge eating and psychological resilience of 3 453 middle school students in Harbin city, Heilongjiang Province. SPSS PROCESS macro program, combined with Bootstrap method, was employed to explore the mediating effect of psychological resilience. The incidence of middle school students experiencing at least one type of abuse in their childhood was 81.3% (2 807/3 453). Childhood abuse, psychological resilience and binge eating were all significantly different in terms of gender, household registration and whether they were only child (all为探讨心理弹性在童年期虐待与暴饮暴食之间的中介作用，本研究对黑龙江省哈尔滨市3 453名初高中生的童年期虐待、暴饮暴食及心理弹性水平进行测评。使用SPSS PROCESS宏程序并结合Bootstrap方法共同探讨心理弹性的中介作用。中学生童年期至少经历过一种虐待类型的发生率为81.3%（2 807名），童年期虐待、心理弹性及暴饮暴食在性别、户籍及是否独生子女方面均存在差异，具有统计学意义（

Oral cavity is one of the main organs involved in chronic graft versus host disease (cGVHD). Oral cGVHD seriously affects the patient口腔是慢性移植物抗宿主病（chronic graft versus host disease，cGVHD）的主要受累器官之一。口腔cGVHD严重影响患者的生命质量，其局部治疗方法主要包括局部使用糖皮质激素等药物、口腔光化学疗法等，是在全身使用免疫抑制剂等药物治疗基础上的重要辅助手段，有时甚至可能是唯一的治疗措施。本文就口腔cGVHD治疗中局部药物及口腔光化学疗法应用的研究做一综述。.

This study was performed to investigate whether the level of acculturation among Asians living in the USA plays a significant role in their opinion of facial profiles. One hundred and ninety-eight Asian American subjects were asked to complete a pre-validated survey to measure their level of acculturation and to evaluate four sets of pictures that displayed a class II male, class II female, class III male, and class III female. Each set consisted of three lateral profile pictures: an initial unaltered photo, a picture simulating a flatter profile (orthodontic camouflage in class II; mandibular setback in class III), and a picture simulating a fuller profile (mandibular advancement in class II; maxillary advancement in class III). For the class II male, subjects who were more acculturated indicated that a flatter profile (orthodontic camouflage) was less attractive. For the class II female, higher acculturated subjects chose expansive treatment (mandibular advancement) as more aesthetic compared to the less acculturated subjects. Each of these scenarios had statistically significant odds ratios. In general, highly acculturated subjects preferred a fuller facial profile, while low acculturated subjects preferred a flatter facial profile appearance, except for the class III female profile, which did not follow this trend.

We investigated the relationship between IGF-I, gender, height, weight, body composition and birth size in 260 healthy 7- and 8-year-old children (139 females). All children were born term at Nepean Hospital, Western Sydney. Body composition was measured using dual energy X-ray absorptiometry. IGF-I levels were determined by radioimmunoassay. Girls had higher IGF-I levels than boys (20.2 ± 6.5 nmol/l compared to 15.9 ± 6.1 nmol/l, p < 0.001) but there was no correlation between age and IGF-I. IGF-I was positively correlated with height SDS (R2 = 0.12), weight SDS (R2 = 0.19), BMI SDS (R2 = 0.18), total body fat (%) (R2 = 0.14), and fat-free tissue/cm (R2 = 0.03). After adjusting for gender and current weight, IGF-I-levels were inversely related to birth size – children with the lowest birth size and heaviest current weight had the highest IGF-I levels. This correlation between birth weight and IGF-I supports the hypothesis that the IGF-I axis is altered in babies who are small for gestational age.

It is known that women have higher levels of high density lipoprotein (HDL) cholesterol than men. The authors examined the association between HDL cholesterol and biologic sex in 8,631 women and 10,690 men aged 45-54 years from six countries studied between 1972 and 1989. The variation in the sex difference for HDL cholesterol was significant; the smallest difference (0.06 mmol/liter) was seen in China and the largest (0.40 mmol/liter) in Canada. Adjustment for differences in body mass index, smoking, alcohol use, and heart rate reduced but did not eliminate the variability. The sex difference in HDL cholesterol levels, usually assumed to be due to biologic factors, differs across cultures and may be related to environmental factors.

Despite the high volume of total hip arthroplasties (THAs) performed in North America, there is no consensus regarding postoperative implant surveillance. Therefore, an Internet survey of Hip Society members was performed to determine the timing of follow-up visits after THA. The surgeons were queried with respect to the time until the first and second postoperative visits and the interval of follow-up for the first and second decades. The average time until the first follow-up visit is 4.9 weeks, and 63% of patients are seen by 6 weeks after surgery. Ninety percent of respondents saw patients at 1 year after THA. Follow-up visits after year 1 were more variable. Guidelines for follow-up should be established to enhance patient outcomes over time.

The effusion cytologies from 21 cases of malignant mesothelioma (MM) (15 pleural, 6 peritoneal) diagnosed at the Indiana University Medical Center during 1990-1997 were reviewed. Using the classification of Tao (Acta Cytol 1979;23:209-213), 13 cases of MM were of the epithelial cohesive cell type and 8 were of the epithelial noncohesive cell type. While the epithelial cohesive cell type has been discussed in the literature, the epithelial noncohesive cell type has not. The cytomorphologic features for both types are presented with particular emphasis on the noncohesive cell type. The differential diagnosis and use of ancillary confirmatory laboratory tests are briefly discussed. Because of its resemblance to florid reactive mesothelial hyperplasia and the general lack of awareness of the existence of the single-cell pattern of mesothelioma, this diagnosis can often be missed.

We present the cytologic, immunohistochemical, flow cytometric and ultrastructural findings of a case of invasive ductal carcinoma of the breast with features of neuroendocrine differentiation occurring in an 83-year-old male. Fine needle aspiration (FNA) cytology of the patient's tumor demonstrated a markedly cellular specimen to discohesive tumor cells, present primarily singly, with occasional loose groups. The cells were relatively large, with pleomorphic, eccentrically placed, round to oval nuclei. The cytoplasm was abundant and contained prominent red granules (Papanicolaou stain) that were also argyrophilic. Immunohistochemical studies performed on the aspirate and the subsequently excised malignant breast tissue revealed positive staining for neuron-specific enolase, chromogranin A, synaptophysin and gastrin. Also, the majority of the tumor stained positive with antibodies to both estrogen and progesterone hormone receptors. DNA flow cytometry demonstrated an aneuploid stemline population with a DNA index of 1.73 and an S-phase fraction of 4.5%. Electron microscopy was performed on the FNA material, and numerous variable-sized, membrane-bound, dense-core granules diffusely scattered within the cytoplasm of the neoplastic cells were identified. The specific cytologic features of this tumor, along with the immunocytochemical and ultrastructural features, can aid the pathologist in rendering an accurate FNA diagnosis of this specific subtype of breast carcinoma.

A case of papillary carcinoma of the thyroid with anaplastic transformation was diagnosed by fine needle aspiration. The atypical history and presentation of this case, the initially problematic cytologic and immunohistochemical findings, and the definitive cytologic and histologic features are described. The diagnostic problems posed by papillary carcinoma of the thyroid with anaplastic transformation are discussed. This diagnosis must be included in the differential diagnosis of poorly differentiated tumors of the neck.

Twenty-six patients were prospectively evaluated with endosonography-guided real-time fine-needle-aspiration biopsy. This cohort comprised 14 patients with a pancreatic mass revealed by CT or a stricture of the main pancreatic duct seen at ERCP, 7 patients with mediastinal lymphadenopathy, 3 patients with extrapancreatic abdominal masses, and 2 patients with subepithelial or infiltrative lesions. Endosonography-guided real-time fine-needle-aspiration biopsy was diagnostic in 18 of 20 patients in whom surgical confirmation was available or in whom malignancy was found and confirmed by clinical follow-up (accuracy of 90%). In the subgroup of patients with pancreatic lesions, 3 had previously undergone nondiagnostic CT-guided fine-needle-aspiration biopsy and 2 did not have evidence of a mass by CT. Real-time fine-needle-aspiration biopsy was diagnostic for malignancy in 4 of these individuals. In the 7 patients with mediastinal lymph nodes, 2 had nondiagnostic transbronchial biopsy and 2 had no evidence of mediastinal lymphadenopathy by CT scan. Endosonography-guided real-time fine-needle-aspiration biopsy diagnosed malignancy in both individuals with nondiagnostic transbronchial studies and was able to identify mediastinal lymphadenopathy in the 2 patients with negative CT scans (malignancy confirmed with real-time fine-needle-aspiration biopsy in 1). Overall, in 9 of 10 lesions in which visualization by CT was not possible (5), CT-guided fine-needle aspiration was unsuccessful (3), or prior nonsurgical biopsy techniques were unsuccessful (2), real-time fine-needle-aspiration biopsy was diagnostic.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of acrylamide on calmodulin (CaM), cAMP, cGMP, Ca2+, Mg(2+)-ATPase and 45Ca2+ uptake in nervous system were determined in Wistar rats (ip, 10 or 50 mg.kg-1 for 12 d). The results indicate that acrylamide caused an alteration in calcium homeostasis in rat brain by decreasing the Ca(2+)-sequestering capacity of microsomes, and this may occur due to an efflux of calcium secondary to a microsomal structure damage. The changes of CaM in nervous system coupled with potential alteration in the intracellular Ca2+ concentration could affect many CaM-dependent enzymes (i.e. Ca2+, Mg(2+)-ATPase) and cyclic AMP system, and CaM or cAMP is known to be "toxicological second messenger" that could initiate neurotoxicity, though more work is needed to elucidate the details of the mechanism.

The clamp shape implant has a special memorial function. It consists of one main rod and 3 or 4 pairs of curved short arms located at both sides of the rod. Each pair of arms rolls into a circle, which can embrace 2/3 of the circumference of the fractured bone shaft, thus fixing fragmental bones at multiple points more securely without any limitation to the motion of adjacent joints. Therefore, clamp implant is especially useful for comminuted fracture of the short tubular bone, which is difficult to fix by other methods.

An analysis of 105 cases of prematures with respiratory distress syndrome, the idiopathic type were 9.5% (10/105). Fetal anoxia and ischemia, induced by pregnancy and during labour amounting to 87.6% (92/105), and of which 2.9% (3/105) was due to diabetes. It indicated that most cases of RDS are predominantly related with fetal anoxia and ischemia which results in pulmonary surfactant abnormality or impaired activity. It is important that in clinical diagnosis one should monitor cautiously the presence of premature birth with anoxia and ischemia, Thus, a preventive treatment must be given at least 24 hours prior to birth, and the earlier the least morbidity of RDS occurred.

To characterize gastric acid response and its age distribution in the patients with duodenal ulcer (DU), we conducted pentagastrin (PG) dose-response study and calculated maximal response (Vmax-c), half maximal dose of PG (Km-c), and the mean response to 0.22 microgram/kg/hr of PG as percent of highest observed response (SI). The mean values of basal secretion (BAO), Vmax-c, and SI in DU were significantly greater than those of normal subjects (N). The mean values of Km-c were significantly less than those of N. The greater BAO, Vmax-c, and SI, and less Km-c were observed in all age groups of DU. The results indicate that DU patients not only secrete more acid but also are more sensitive to stimulation by pentagastrin than N, and that the characteristics are common in all age groups of DU.

The cytologic features of clear cell hepatocellular carcinoma are described. This tumor may cause a diagnostic dilemma since it resembles other clear cell tumors originating in the adrenals, kidneys and ovaries. However, clear cell hepatocellular carcinoma possesses some characteristic features that permit a cytologic diagnosis to be made by fine needle aspiration, thus contributing to proper management.

Breath alcohol analysis of 449 patients with motor vehicle injuries attending the emergency department of a Taiwan urban general hospital during a 10-week period showed that 19.2 per cent had breath alcohol concentration (BAC greater than 0.002 per cent and 8.5 per cent greater than or equal to 0.05 per cent). Injured males were more likely to have BAC greater than or equal to 0.05 per cent than women (11 per cent vs 0 per cent). Injuries resulting from alcohol-associated collisions were about 6.7 times more likely to occur between 1800 and 0600 than at other time periods. A telephone survey after hospital discharge showed that the risk factors of alcohol use, speed at time of collision and type and site of collision were significantly associated with degree of economic loss resulting from the accidents. Logistic regression analysis showed that the odds of high economic loss associated with BAC greater than 0.002 per cent were three times greater than for persons in whom no alcohol was detected. This is the first study in Taiwan to use breath alcohol analysis in assessing the effect of alcohol consumption on motor vehicle injuries. The results show that alcohol use is an important cause of motor vehicle injuries. Preventive measures such as strict legal control of drunk driving and limitation of the hours that drinking places can stay open at night are recommended to reduce the damage caused by this severe public health problem.

In searching for effective anticonvulsant agent fourteen 6-(substituted-phenyl)-4,5-dihydro-3 (2H) pyridazinones and fifteen 6-(substitutedphenyl)-3 (2H) pyridazinones have been synthesized and screened in mice for their ability to antagonize maximal electroshock seizure (MES). The ED50 values showed that 6-(2',4'-dichlorophenyl)-3 (2H) pyridazinone was the most potent anticonvulsant in these compounds. The structure--activity relationships in these two series were examined. We came to the conclusion that the higher is the hydrophobic parameter pi of the substituent on phenyl ring, the more potent anticonvulsant is the compound. And also, only the compounds with an electronwithdrawing substituent on the phenyl ring exhibited appreciable anticonvulsant activity.

Two experiments were conducted to estimate total non-protein energy and nitrogen requirements in growing healthy male Wistar rats nourished by parenteral nutrition. In experiment 1, non-protein energy varying from 30 to 70 kcal/day/rat were administered to animals receiving a constant dose of 80 mg nitrogen, plus vitamins and minerals. In experiment 2, nitrogen dosages varying from 0 to 280 mg N/day/rat with a constant dose of 60 kcal non-protein energy were studied. The formulation of the amino acid solution used in both experiments was based upon recommended oral amino acid requirements for growing rats. Dextrose served as the source of non-protein energy. Weight gain and nitrogen balance during a 6-day experimental period were used to determine requirements. Plasma free amino acids were also analyzed to evaluate the amino acid solution. Results indicate that under total parenteral nutrition conditions 578 to 621 mg/kg body weight3/4 nitrogen and 171 to 182 kcal/kg body weight3/4 non-protein energy are required to achieve growth of approximately 3 g/day. Inconsistent responses of plasma amino acid concentrations to the amounts infused were observed. It is suggested that the determined requirements can be applied as guidelines to research using the rat as an animal model in total parenteral nutrition.

The purpose of this study was to evaluate the effect of increased arginine levels in intravenous hyperalimentation (IVH) therapy on wound healing and thymic immune function. Groups of SD rats, 275-325 g, underwent placement of internal jugular catheter, 7-cm dorsal skin wounding, insertion of polyvinyl alcohol sponges subcutaneously, and closure of wounds with stainless-steel sutures. Twenty-four hours later, rats were started on IVH at a rate of 0.8-1 ml/100 g body wt/hr. All IVH solutions contained 20% dextrose, adequate amounts of minerals and vitamins, and two different amino acid mixtures: (A) Fre III (4.05 g ARG/liter) (n = 13); (B) experimental (7.50 g ARG/liter) (n = 11). Solutions were isonitrogenous, and contained similar amounts of essential amino acids. After 7 days of IVH, weight gain did not differ between the two groups; however, cumulative N balance was superior in group A. Wound healing was improved in group B as assessed by fresh wound strip breaking strength, fixed breaking strength, and the amount of reparative collagen deposition as assessed by the hydroxyproline content of the implanted sponges. Group B animals also had improved thymic function as assessed by thymic weight, the total number of thymic lymphocytes/gland and mitogenic reactivity of thymic lymphocytes to PHA and Con A. The experiments indicate that high arginine levels in IVH solutions improve wound healing and thymic immune function following injury.

The optimal levels of arginine (Arg) for growth and immunity were studied in mildly depleted, noninjured rats maintained on intravenous hyperalimentation. Three groups of S-D rats (eight/group, weighing 275-300 g) underwent catheter insertion, 1 day of fasting, and then 7 days of intravenous hyperalimentation consisting of 20% dextrose, adequate minerals and vitamins, and three amino acid regimens: (1) FreAmine II (1.55 g Arg/liter); (2) FreAmine III (4.05 g Arg/liter); (3) experimental (7.5 g Arg/liter). The increase in arginine levels was achieved by lowering the glycine levels. There were no differences among the groups in terms of body weight gain (6.9 vs 8.3 vs 10.0 g) or in cumulative N balance (574 vs 660 vs 642 mg). Liver, spleen, and adrenal weights did not differ. Thymus weight was greater in groups B and C: (A) 345 +/- 27 mg vs (B) 445 +/- 34 mg, p less than 0.05, vs (C) 438 +/- 26 mg, p less than 0.05) as were the total number of lymphocytes/thymus (X 10(-9) (A) 0.93 +/- 0.12 vs (B) 1.37 +/- 0.18, p less than 0.05, vs (C) 1.46 +/- 0.15, p less than 0.05). Mitogen-induced thymocyte blastogenesis (cpm) was greatest in group C in response to phytohemagglutinin: (A) 9.558 +/- 3,799 vs (B) 20,088 +/- 5,890, NS, vs (C) 37,234 +/- 6,209, p less than 0.01 vs A and p less than 0.05 vs B) and Concanavalin A: (A) 71,035 +/- 15,228 vs (B) 111,734 +/- 15,021, NS, vs (C) 172,967 +/- 19,861, p less than 0.01 vs A and p less than 0.05 vs B). In the intravenous hyperalimentation-maintained noninjured rat ARG concentrations more than 1.55 g/liter do not enhance N retention or growth. Larger doses of ARG have strong thymic immunostimulatory effects without any toxicity or growth reduction.

The diagnosis of diffuse malignant infiltration of lung is often made with certainty only by open lung biopsy or at autopsy. However, the clinical presentation and radiological examination are often sufficiently characteristic to suggest the diagnosis. Percutaneous fine-needle aspiration biopsy (PFNAB) has been reserved mainly for the diagnosis of focal lesions of lung and has been reported not to be useful in the diagnosis of diffuse lung disease, especially when the latter is mainly interstitial. We report 15 patients with radiologically diagnosed diffuse interstitial infiltration of lung, 13 of whom had lymphangitic carcinomatosis either on clinical follow-up, cytological or pathological examination. Cytology by percutaneous fine-needle aspiration biopsy was positive for malignant cells in 11 of the 13 patients. We propose that PFNAB be used early in investigation when the clinical and radiological findings suggest that a patient has diffuse malignant interstitial lung infiltration.

Mortality data obtained from the Health Statistics Office of the Ministry of Health, People's Republic of China (PRC), were compared to data for other countries taken from the World Health Statistics Annual. The crude death rate for coronary heart disease (CHD) in China in 1984 is estimated to be about one-tenth of that for North America and Australia. However, a high stroke to CHD ratio of about 5.0 was observed in China. The age-standardized CHD mortality rates were significantly higher for Beijing in north China than for Shanghai and Guangzhou in the south, and for urban than rural populations in all years from 1976 to 1986. Data on hospital admissions and autopsy material provide evidence for an increase in CHD incidence and prevalence in the last three to four decades. A low mean serum total cholesterol, related to a low habitual dietary intake of fat and cholesterol, is considered to be the main cause underlying low CHD mortality rates in China.

A fine needle aspiration biopsy specimen of a retroperitoneal mass was submitted for cytologic evaluation. Malignant cells were found, and the cytologic appearance was consistent with seminoma although the clinical possibilities included lymphoma and adenocarcinoma of the pancreas. Cytologic features of the needle biopsy specimen included uniform neoplastic malignant cells with round nuclei and nucleoli and clear or pale-staining cytoplasm. The cells were found singly or in groups of two or three cells. Lymphocytes were intermingled with the neoplastic cells.

By means of X-ray photography tests were made of 224 (100 males and 124 females) volunteer Chinese adults of Han nationality to study the related regular patterns of superimposed projection of face landmarks onto the skull. On the basis of these tests, the present article reveals from a forensic anthropology angle the related regular patterns of plane projection of the human face with its skull. Study shows that there exist a strict individual identity and exclusiveness in relation between the human face and skull. The related regularity of displacement of face landmarks appears in projection of the skull with the human head at different photographic positions and angles. On the basis of this discovery, 52 indexes in 4 groups were established as a standard for judging the identification of a skull's body origin by means of skull-image superimposition. Based on forensic anthropology, the technique has raised to a great extent the credibility of unknown skull identification. In the past 8 years, 89 unknown skulls have been identified with their body origins which provided important and accurate evidence for the solution of murders with dismembered bodies, skeletonized bodies, and unidentified dead bodies.

Carnitine is an essential metabolite whose function is to transport activated long-chain fatty acids across the mitochondrial membrane. It is consumed in the diet and is synthesized from lysine and methionine to meet body needs. Hepatic fat deposition has been reported in experimental animals and patients receiving total parenteral nutrition (TPN) fluids devoid of preformed carnitine. In the present experiment, nitrogen balance, hepatic fat deposition and serum and tissue carnitine were determined in rats receiving a hypercaloric TPN regimen containing 0, 10, 50, and 100 mg DL-carnitine per 100 g body weight for 14 days. Rats fed a stock diet served as controls. Increased nitrogen balance was observed in TPN rats receiving the highest dose of carnitine supplementation. Hepatic fat deposition induced by the hypercaloric infusion was ameliorated but not eliminated by infusing carnitine. Serum, liver and skeletal muscle carnitine concentrations were maintained, whereas that of heart decreased in TPN rats without carnitine supplementation. Between 90 and 100% of the administered L-carnitine was excreted. It is suggested that the observed effects of carnitine on nitrogen balance and hepatic fat deposition are due to as yet undefined pharmacological properties. The significant decrease of carnitine in cardiac muscle resulting from TPN in a patient population already stressed and traumatized and the metabolic and physiological effects of this decrease deserve further exploration.

Adrenal tuberculosis remains an important cause of Addison's disease. Acute tuberculosis adrenalitis may produce mass-like enlargement of the glands which requires differentiation from primary or secondary neoplastic disease. Using percutaneous fine-needle aspiration biopsy, the authors made the diagnosis of tuberculosis adrenalitis in two patients who presented with Addison's disease; and enlarged adrenal glands seen using computed tomography.

With the introduction of transbronchial brushings and fine needle aspiration biopsy, which enable us to obtain samples directly from lesions, the diagnostic potential of cytology for the detection of malignancy, including early cancer, has been greatly enhanced. From 1976 to 1982, five positive cytology reports were initially considered to be "false positives" on the basis of negative gross findings, benign operative biopsies or negative histologic findings in the resected surgical specimens. However, these proved to be false "false positives," based upon the clinical follow-up or further examination of the surgical specimens. Presentation is made of three of these cases with positive cytologic findings and initially negative histologic diagnoses, with an analysis of the causes of the latter. From our experience, four types of cancerous lesions seem prone to being missed during gross examination, namely: any small cancer with a consistency similar to that of the parenchyma of the organ in which the tumor is located, superficially invasive carcinoma, scar cancer and a radiologically occult lung cancer in the presence of a coexisting radiologically demonstrable lesion. With more clinical application of these cytologic methods, false "false positives" are expected to occur more often.

From 1978-1980, 20 patients with radiographically occult squamous cell carcinoma of the lung were admitted to Toronto General Hospital. Among them, five had in situ carcinoma, three had microinvasive carcinoma, and 12 early invasive. All cases were first diagnosed by cytologic examinations of sputum, localized by bronchoscopy, and had been verified histologically. It appears that a cytologic diagnosis of in situ squamous cell carcinoma of the lung could not be established on the basis of a single abnormal squamous cell or an occasional group of abnormal cells, but could be reached by putting together all the cytologic findings observed in the preparations. The criteria for the cytologic diagnosis are elucidated. Cytomorphologically there was no difference between microinvasive and advanced invasive carcinoma. However, in a patient with known localized in situ carcinoma and previous persistent cytologic findings of the same from that particular site, the finding of frankly malignant cells from the same site in the follow-up bronchoscopic examination was almost definitely an indication of microinvasive carcinoma, which usually showed evidence of both in situ and invasive carcinoma in the bronchial brushing specimens. None of the three microinvasive carcinoma cases had positive lymph nodes, but four of the 12 patients with early invasive carcinoma had metastases to the nodes at the time of surgery. Hence, the best time to effectively treat the invasive squamous cell carcinoma of the lung is at the microinvasive stage when the disease is considered curable.

A fine needle aspiration specimen from the right lung of a 44-year-old former drug addict was submitted for cytologic evaluation. The specimen consisted of numerous mononucleate and multinucleate macrophages containing aggregates of silicate crystals, as seen by light microscopic examination using a polarizing filter. The background of the slides included fibroblasts, lymphocytes and other inflammatory cells. The finding within foreign-body giant cells of large groups of strongly birefringent, platelike crystals varying widely in size led to the conclusive cytologic diagnosis of intravenous talc granulomatosis.

Percutaneous fine-needle aspiration biopsies were performed in 51 patients with various intra-abdominal masses localized by palpation, radiologic studies, ultrasonography or radioisotope scanning. Biopsy specimens were considered positive for malignant disease in 35 (85%) of the 41 patients with such disease, including 26 (96%) of the 27 with metastases. There was one false-positive diagnosis of malignant disease from the biopsy specimens. Surgery became unnecessary as a result of aspiration biopsy in at least 12 patients. One patient showed evidence of intrahepatic bleeding during liver biopsy but recovered spontaneously, and the liver appeared normal at laparotomy 3 weeks later. Aspiration biopsy is an accurate, relatively painless, inexpensive and safe method of establishing a diagnosis of intraabdominal malignant disease. Considerable experience of the cytologist is necessary for good results.

Adult sheep were prepared to receive total nutriment by dual infusions. Volatile fatty acids were infused intraruminally and glucose, vitamins, and amino acids via jugular cannula. Methionine and glycine were varied to provide isonitrogenous amino acid infusion with levels of 0, 0.75, 1.50, 2.25, 3.00, 3.75, 4.50, 5.25, and 6.00 g of methionine/day. Urinary nitrogen (UN), plasma urea nitrogen (PUN), urinary urea nitrogen (UUN), and nitrogen balance (NB) responded curvilinearly to increased methionine infusions. The point at which a tangent to the curve had a slope of zero was taken as the level at which methionine was no longer limiting. This occurred at infusion levels of 4.81 to 5.00 g/day. Plasma methionine increased sharply at infusion levels of 3.63 g/day. Most plasma amino acids were influenced by levels of methionine infusion with nonessential amino acids being higher when methionine was limiting or in excess. Plasma insulin and plasma glucose were also influenced by level of methionine infusion with plasma insulin responding in a manner similar to PUN, UN, UUN, and NB. J. Nutr. 104: 1646-1656, 1974.

Pulmonary blastoma is one of the least common primary malignant tumors of the lung. There is considerable controversy as to its exact histogenesis; it is uncertain if it arises from a single cell or if it is a mixed tumor arising from two different cell lines. We report three patients with pulmonary blastomas, describing in detail their radiological, cytological, and histopathological features.

Fifty-seven cases of mesothelioma from the Toronto General Hospital during the period 1965 to 1976 have been reviewed. Pleural effusions or ascites were present in 34 patients. The value of cytologic examination of effusion specimens was assessed, and the criteria for cytologic diagnosis were elucidated. It appears that patients with predominantly fibrous or sarcomatous mesothelioma were not prone to develop pleural effusions or ascites; few tumor cells, if any, from these mesotheliomas were exfoliated into effusions. Cytologic examinations of effusion specimens were positive in 12 of 14 cases of carcinomatous mesothelioma and in three of four cases of undifferentiated mesothelioma. However, only four of seven casee of benign mesothelioma (mostly epithelial type) showed positive results, as did two of four cases of sarcomatous mesothelioma. It appears that cytologic diagnosis of mesothelioma is more useful for the carcinomatous and undifferentiated types. The cytomorphologic features of the various types of mesothelioma are different, and by cytologic examination of effusion specimens, typing of mesothelioma is possible and correlates well with the histologic typing.